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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416545
Report Date: 04/11/2024
Date Signed: 04/11/2024 10:17:12 AM

Document Has Been Signed on 04/11/2024 10:17 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:WANG, WENJINGFACILITY NUMBER:
434416545
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 3CENSUS: 2DATE:
04/11/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Wenjing WangTIME VISIT/
INSPECTION COMPLETED:
10:40 AM
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Licensing Program Analyst (LPA) Mel Matos met with Wenjing Wang, Licensee, for an unannounced Annual/Random inspection. Note: Licensee has also applied for a capacity increase and a fire clearance approval was received from the San Jose Fire Department on March 21, 2024. LPA was granted access to the home by the Licensee. LPA also observed two of Licensee's own children (10 months & 3 year old) in the home during today's inspection. Licensee states that she has one day child enrolled at this time (starting 04/15/2024). Licensee understands that she must always operate within her capacity and ratio requirements. LPA observed the required postings, including the facility license, near the front entrance to the day care area. Days and hours of operation are Monday - Friday from 8:30 AM to 6:00 PM. The adults residing in the home are: Licensee and Licensee's spouse (Yulei Wang). Licensee has three minor children residing in the home, ages 5 & 3 years and 10 months.

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. Licensee has her own three children listed on the Child Care Facility Roster. The last fire/disaster drill was completed on January 8, 2024. Licensee states that she has applied for liability insurance for her day care through Merkel Insurance and LPA observed an application packet. Licensee has current CPR and First Aid certifications (exp: 12/2024). Licensee has the required vaccines (MMR, Tdap, & flu) and is current with her Mandated Reporter Training for Child Care Workers (exp: 12/20/2024). LPA reviewed three children's files and the files were complete with the required forms, including the Individual Infant Sleeping Plan (LIC 9227) & infant sleeping logs. LPA reviewed one staff file (Licensee) and the file was complete with the required forms.

LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a valid phone in the home (408-669-9467). The home is clean, orderly, (including heating/air conditioning/ventilation), and safe for the day care children. There are safe & age appropriate toys, play equipment, and materials for the children in the home. There are not any stairs or wall heater units inside the home. Off limit areas inside the home: barricaded fireplace in the living room area, bedrooms 1 & 2, 1 bathroom, and attached garage. Off limit area outside the home: entire backyard. Licensee states that the children utilize the fenced front yard area for outdoor play and activities. Licensee understands that children must be supervised at all times while outdoors in the front yard area.

LPA observed a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detectors, no bodies of water (other than aquarium listed below), and fenced backyard. Licensee states that she does not have any weapons in the home. There is a 40 gallon aquarium (with at least one dozen goldfish inside), located in the kitchen area of the home, that is safe and secure. LPA reminded Licensee that all pet food and cleaning products must be kept inaccessible to the day care children. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. Licensee states that there are no poisons in the home.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: WANG, WENJING
FACILITY NUMBER: 434416545
VISIT DATE: 04/11/2024
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Licensee states that she provides all meals for the children (including snacks and lunch). Licensee states that all food brought from home is labeled with each child's name and properly stored. Licensee has a first aid kit in the home which includes a touch less thermometer. Licensee states that nobody smokes and she understands that smoking is prohibited in the home.

Licensee states that she does not administer any medications to the day care children. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity/ratio options and she understands that she cannot have more than 14 children present in the home without two qualified adults present. Licensee understands that she must comply with the ratio/capacity requirements of the small license if only one qualified present in the home. Licensee states that a child will be isolated in the living room area if necessary due to illness or communicable disease. Licensee states that does not transport any day care children. Licensee understands that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

Wenjing Wang, Licensee, was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with the Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.



Exit interview conducted and report was reviewed with the Licensee, Wenjing Wang. Licensee was advised that a large Family Child Care Home license is approved as of today, April 11, 2024. No deficiencies issued during today's inspection. A Notice of Site Visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
LIC809 (FAS) - (06/04)
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